This leaflet has been written to provide information about a procedure to examine the area in the centre of the chest, between the lungs (Mediastinotomy/Mediastinoscopy). We hope it answers some of the questions or concerns you may have about the procedure. It is not intended to replace talking with medical or nursing staff.
What is a Mediastinotomy / Mediastinoscopy?
Mediastinotomy / Mediastonoscopy are procedures to examine the area in the centre of the chest, between the lungs (Mediastinum). A tissue sample (called a biopsy) may be collected during the procedure and later examined under a microscope for signs of lung conditions or infections.
How is it done?
You will be given a general anaesthetic and therefore you will be asleep during the procedure. Once you are asleep a small incision will be made in your neck or your chest. A small camera is inserted through the incision allowing your doctor to carefully examine the space in your chest between your lungs and heart (Mediastinum). A sample of any suspected abnormal tissue may be collected and later examined. The camera is then removed and the incision closed using dissolvable stitches.
How long does it take?
The procedure takes approximately 1 hour although this can vary.
Will I have any pain or discomfort following the procedure?
You may feel slightly uncomfortable after the procedure but you will be given medication to help control this. Alternatively you may be given a special pump to treat any pain or discomfort. The pump is attached to you by a small tube, usually in the back of your hand. You will be given a hand held button which delivers a measured amount of pain relieving medication through the tube each time you press it. You will be told how to use the pump if your doctor feels this is appropriate for you.
How do I prepare for the procedure?
You may be invited to a pre admission clinic prior to your admission date, to prepare you for your procedure.
Normally you will be admitted to hospital the day before or the morning of the procedure. If you haven’t already had investigations at pre admission clinic, you may need to have a chest x-ray, a heart tracing (ECG), routine blood tests and a breathing test.
You will be given an antiseptic wash to use before the procedure to help prevent infection. You will be informed when to stop eating and drinking prior to the procedure.
What are the benefits of having the procedure?
The procedure can help your doctor to locate and diagnose diseases or infections that affect the lungs and mediastinum (area between the lungs and heart).
It is not a treatment for these conditions but it will provide important information which will allow your doctor to determine if you require treatment and discuss any treatment options with you and your family.
What are the risks involved?
There is a small risk of bleeding from the incision site and you may experience a small amount of bruising.
There is also a small risk of infection.
More serious but rare complications include, heavy bleeding, causing a tear to the throat (oesophagus) and collapsing a lung during the procedure (pneumothorax). If this were to happen you may require treatment to reinflate the lung.
Any risks involved with the procedure will be discussed with you in more detail before you sign a consent form.
What alternatives do I have?
This depends on your condition.
Other tests that provide information about the lungs and chest include CT scans, bronchoscopy, (involves passing a scope down your throat in order to examine the windpipe and entrance to the lungs), breathing tests and chest X-rays. A Mediastinoscopy however may still be needed if these tests cannot be used or when they do not provide conclusive results.
Your doctor would be happy to discuss any alternative investigations if they are applicable to you.
What can I expect after the procedure?
After the procedure you will be taken to a recovery room in theatre and closely monitored before returning to the ward. Once back on the ward staff will check your heart rate, blood pressure, oxygen level and wound site. Staff will inform you when you are able to eat and drink.
When can I resume normal activities?
You will usually be able to go home the same day or the following day after the procedure. You will be informed how to care for the wound and arrangements will be made for removal of any stitches if appropriate. You must not drive for 1 week and you should take about 1 week off work. You will be reviewed as an outpatient following the procedure and given the results of the biopsy. This advice will be discussed in more detail before you go home and you will be given an advice sheet.
For further information
- www.nhsdirect.nhs.uk
- www.dipex.org www.lunguk.org
- The British Lung Foundation North West on 0151 228 4723
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